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HomeMy WebLinkAbout1904 Dectaration af Domicite ana v~tizensn~p . . TO THE C1.EAK OF THE C1RCUIT COURT. '3~ss~0 ST. LUC I E ~,pU~y. ~,p~A: • : TAis b any deeluation ot Domiclle aad Citiseashlp iA ths State ot ~lo~ida tbat I am ~ this d~y ia ~eeoedanes. aad ia conformitr with Sectlasa 222.17. I~`lorida 3tatutes. I w?as to~ a kgaJ resideat ot ~f,-~~k ~ T ~~~neCCe~ ~ I ~ . ~ca~,~ ~s~.~.~? resided at ~r~o , i~Ai n i G~,,, I~Oa - Ho~?~e,rer. I aave eluaged my domicik to ° T- t t+~K-i~d No~b~N ~ ~ and am and bave beea a bona fide t~estdent ot tAe State at Flucida ainos c da~? ot ~ l9~ and I reside aL . • ~ l6teMt vd Nrm~l ?zk T1e~~~P , ~ ST. lUG IE Ca,otr.~a cc~?~ aad this statemedt is to 6e takea u apr declantion oi ati~ea~hip. actuai kgal resideaos and doadak in tbs State at FMrida. IF FOR THE PURP~SE Of ENROLLING Ii iOR HOMEStEAG PURPOSES~ CHIL~REN tN SCHOOL~ P4EASE STI?TE P~EASE CHECK: ~ THEIR NAMQSt . iilEC s~: R~COitQEO ' sT. LIiC1E ~OUMTY fLA. ROGE?~ F~t~RAS CLERt C~~CtAT COURT Rf.r,~~~ Y~ ~ ~=iEi? ~ S~r t i !i s8 I~'~5 ~ . 31fi~2p I FiJRTHER CERTIFY that 1 will register at my local address when the registration booi~s reopen, aad eomply arith aU other requirements of s legal resident ot tbis Stale. ± 1 FURTHEr'i CERTI that I have no int~ntion to return to my former doraicile. and I iatead to remain in ~ ' ~i2t- ? ev~t f_ E , ST . L UC 1 E . County. (~7) . ~ F'lorids, permancnti; . ' . - v r' - ~ ~ ~ :t~.N: ~ ~ }~';~~ZK • . sti~~'~t,-~~.~CO~ _ . ~v~0~~ !'~.~5 - ~ • -r ~ . . ~ • ~ ~ ~~Yh. ~ = ~~:•y,~ . ~ ~ ~"',~:#~'~a ~o : ~ _ ~ r , : i > ' ~ ` J" : .~~;.1 ~ ? ~ {(,t. ' : ~ ~ ~ ` . ~ ~ : :r ~ - ~ C : ~4i ~ ~ Ct~ ~ ~ rn ~'~~~~~~~~:.i`,~ ~~1 i. : ~ . t'60~.~` tNamO) ~ . ~ ~~l • ` I ~tU ' : t,t,,~,,:,, ~ s ~ (Addna) I Sworn to and subscribed before me this ~ day ot ~ ~ } ~ . A.D.19 7~ ROGER POi TRAS, CLERK OF C iRCUi T COl~2T SY. t_UC i E GQUNTY, FLOR t DA BY: 1 r E P Y L E R K BOOK !.~'Zt~ PAGf 1904 AGO Porm TI-22 ~ J"~, ~ , : ' - - _ _ <F'"_z.:~~' . n=...R. ~ti ~